Surgical observations : being a quarterly report of cases in surgery, treated in the Middlesex Hospital, in the cancer establishment, and in private practice : embracing an account of the anatomical and pathological researches in the School of Windmill Street / by Charles Bell.

  • Charles Bell
Date:
1816
Catalogue details

Licence: Public Domain Mark

Credit: Surgical observations : being a quarterly report of cases in surgery, treated in the Middlesex Hospital, in the cancer establishment, and in private practice : embracing an account of the anatomical and pathological researches in the School of Windmill Street / by Charles Bell. Source: Wellcome Collection.

Provider: This material has been provided by University of Bristol Library. The original may be consulted at University of Bristol Library.

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    It may be necessary to draw the attention of my younger readers to the chief circumstances of these cases. 1. It appears that punctures of the scrotum are insufficient even to empty the cellular texture of the extravasated urine, and quite unfit for prevent- ing the urine taking the same course a second time. If the lancet be used, the shoulder must be moved, while the point is kept at rest, so as to make a large opening in the skin. 2. For the most part the urine bursts into the perineum, and is carried by the fascia of the peri- neum forward into the looser scrotum.* In this case the opening into the scrotum must be at the back part, and the point of the instrument directed backwards, so as to give issue to the urine as it escapes from the perineum. 3. But it will be seen here, that the extravasa- tion takes place sometimes more anteriorly, and the (edema of the preputium is the first sign of the approaching danger. In all cases, therefore, it is proper to sound the urethra with a bougie [and this should be done in the gentlest manner] to as- certain the place of stricture, and that the puncture may be directed with reference to the spot from whence the urine issues from the urethra, and which is always behind the stricture. 4. The urine has a deadening effect on the cel- * Turn to the observations of Mr. Abernethy. 1 say turn to them, for no surgeon should be without that valuable work.